988 Suicide and Crisis Lifeline

The National Suicide Prevention Lifeline is now the 988 Suicide and Crisis Lifeline (although the previous 1-800-273-TALK (8255) number for the Lifeline will continue to function indefinitely). AFSP has worked with Congressional partners, other non-profit coalition members, and mental health agencies to lead the charge for a 3-digit suicide prevention, mental health, and substance use crisis hotline. From advocating for the Lifeline itself to encouraging budget allocations for the Lifeline’s implementation and maintenance, AFSP has been at the forefront of this movement. AFSP supports increases in federal and state funding for the future 988 crisis response system, including the 988 Suicide and Crisis Lifeline and its network of independently operated state and local crisis centers. Download our issue brief to learn more about AFSP’s policy position and efforts to support the 988 Lifeline and crisis response services.

As of July 16, 2022, 988 is the new three-digit dialing code for the National Suicide Prevention Lifeline, now called the 988 Suicide and Crisis Lifeline. Anyone, anywhere in the U.S. can now call, chat, or text 988 and receive resources and supports during a suicide, mental health, or substance use crisis. Connecting a national network of over 180 independently operated state and local crisis call centers, 988 links callers throughout the U.S. to immediate crisis care. Ideally, callers are connected with a local counselor in their own state. However, if the local center is unable to answer, the Lifeline reroutes calls to backup centers in their network, both in- and out-of-state. Currently, the Lifeline provides live crisis center call, text, and chat services in English and Spanish and uses Language Line Solutions to provide caller translation services in over 240 additional languages.

The recent transition from the Lifeline’s 1-800-273-8255 number to the easily memorable 3-digit 988 dialing code represents a monumental opportunity to transform the way we as a country respond to suicide, mental health, and substance use crises. However, insufficient funding and limited capacity to respond to an increasing call volume could hinder the positive impact 988 can have. As the Lifeline’s national and local call centers have geared up for the transition to 988, AFSP has been advocating for increased funding to expand the Lifeline’s capacity, infrastructure, and workforce.

The Substance Abuse and Mental Health Services Administration (SAMHSA) predicted that, in the first year of 988 operations, contacts to the Lifeline would increase more than twofold. This massive increase in demand must be met with adequate resources and supports so that anyone in crisis, regardless of where they are or what time it is, has someone to talk to, someone to respond, and somewhere to go. It is vital that 988 serves as a bridge across the entire crisis care continuum, from call centers to mobile crisis response teams to crisis stabilization facilities, and critical investments will make this possible. While the transition to 988 is just the beginning, and fully realizing a broad, comprehensive crisis response system will likely take years, AFSP has been working hard to urge Congress and state legislatures to take the necessary steps now to sufficiently meet the rising demand for suicide, mental health, and substance use crisis services.

The ultimate goal of 988 is to provide an effective alternative to 911 and law enforcement response to a suicide, mental health, or substance use crisis, so that individuals experiencing a crisis can receive appropriate and supportive assistance during their time of need. Far too often, a mental health call to 911 has resulted in tragedy for those who require a mental health response to their emergency. The 988 and 911 systems will need to be closely coordinated to seamlessly allow referral of callers for appropriate care or response that addresses the unique circumstances present with each crisis encounter. SAMHSA is actively engaged with 911 counterparts at the federal, state, and local levels to plan for smooth coordination between the two services.

Currently, 988 does not have geolocation services, which means that if a person reaches out to the Lifeline by phone, chat, or text, their exact location cannot be tracked or automatically shared with law enforcement. Most calls to the Lifeline result in de-escalation and the dissemination of resources and follow-up services without requiring an in-person response. The Lifeline’s counselors do not need a caller’s location to connect them with relevant mental health resources, unless the caller specifically wants information on local programs and supports. Callers also do not need to disclose any personal information to receive assistance from Lifeline counselors.

988 is intended to provide support and services, with an eye towards person-centered treatment and stabilization through the least invasive intervention possible. While occasionally crisis centers must work with emergency services to ensure the safety of a person who is in immediate danger, the reality is that these instances are rare and only occur when the caller is at the highest level of risk – resulting in fewer than 2% of Lifeline calls requiring in-person emergency response. The Lifeline’s Imminent Risk Policy outlines when call information should be shared with emergency services. In these cases, the connections only occur when rigorous criteria for an active rescue is met – such as an ongoing suicide attempt when the caller’s imminent safety is at risk. When a caller is determined to be at imminent risk, crisis counselors are responsible for connecting with public safety answering points (PSAPs) to provide any available information to assist the PSAP in locating the individual and ensuring their safety. Click here to learn more from Vibrant, the current administrator of the Lifeline.

Going forward, SAMHSA and Vibrant will work with emergency services at the federal, state, and local levels to strengthen the protections for those contacting 988 and to preserve their privacy and ensure their safety. 

To learn more about the policies that AFSP advocates for in order to sustain and support funding for the 988 Lifeline, please read our one pager here.

To help answer questions from legislators and other decision-makers about 988 legislation and state budget funding, AFSP and Vibrant collaborated on Frequently Asked Questions: 988 & Crisis Response Services

With input from AFSP and several other key partners, NASMHPD’s 988 State Model Bill: Core State Behavioral Health Crisis Services Systems has been updated to address behavioral health equity, health equity, 988/911/law enforcement coordination, financial stability, integration of SAMHSA's National Guidelines for Youth, Young People, and Families, as well as billing/coding assistance.

NASMHPD summarizes actions states are taking to finance and strengthen their crisis response systems in States' Options and Choice in Financing 988 and Crisis Services Systems, including specific examples of state legislation.

AFSP is proud to be part of the NAMI-led initiative #ReimagineCrisis Response – the site includes crisis response stories from across the country, details on the main components of an effective crisis response system, and a map of state 988 implementation legislation. The #ReimagineCrisis 988 State Advocacy toolkit includes a 988 State Advocacy Question & Answer, a collaborative effort by AFSP, NAMI, and Vibrant to guide advocates and address other commonly asked questions.

Consensus Approach and Recommendations for the Creation of a Comprehensive Crisis Response System
Crisis Now: Overview of Crisis Funding Sources Available to State and Localities (2022)
NASMHPD 988 resources
National Association of Counties (NACO): County Funding Opportunities to Support Community Members Experiencing a Behavioral Health Crisis (Funding Chart) (2023)
SAMHSA: 988 Partner Toolkit
SAMHSA: National Guidelines for Behavioral Health Crisis Care: Best Practices Toolkit (2020) SAMHSA: National Guidelines for Child and Youth Behavioral Health Crisis Care (2022)
The 988 Formative Research Project: 988 Messaging and Communication Report and Toolkit (2023)
Vibrant 988 Resources

988 Suicide and Crisis Lifeline – Phone, text, and chat support available 24/7
Dial 988 (English & Spanish, plus translation services in 240+ more languages)
Text 988 (English & Spanish)
For Veterans (Veterans Crisis Line) – 988 (press 1) or text 838255
En Español – 988 (oprima 2)
For LGBTQ youth and young adults (up to age 25) – 988 (press 3)
Deaf + Hard of Hearing - For TTY Users: Use your preferred relay service or dial 711 then 988
Lifeline Chat — English and Spanish

Crisis Text Line – Text support available 24/7 
Text TALK to 741-741

Trevor Lifeline – Phone, chat, and text support for LGBTQ youth
1-866-488-7386 (available 24/7)
Text START to 678-678 (available M-F 3-10pm Eastern/ 12-7pm Pacific)

Trans Lifeline – Phone support for transgender people, by transgender people available 10am-4am Eastern
1-877-565-8860

SAGE LGBTQ+ Elder Hotline – Peer support and resources for older LGBTQ adults available 24/7
877-360-LGBT (5428)